"Do They not travel through the land, so that their hearts (and minds) may Thus learn wisdom and their ears may Thus learn to hear? truly it is not their eyes that are blind, but their hearts which are In their breasts." [al-Hajj: 46]

Archive for December, 2010

It was 8pm, when the SN informed me regarding a terminally-ill patient; a young lady, at her 30s, deteriorating, while her children helplessly looking at her, unable to understand what really happened to their beloved mother. Weakened by her advanced metastatic disease, she was unable to hold her crying daughter. The relatives kept calling for me, the ‘night-shift’ doctor, asking what else could be done to lighten her unbearable pain.

The environment really gave me a heart ache. This lady with androgenic appearance reminded me of my late aunt, who died of advanced stage cervical & ovarian cancer. It was as if she was right in front of me, gasping for air at her last moments before she departed from this world. I tried my best to hold my emotions, acting cool, examining the patient as if ‘this is just another case’ waiting for the death angle to come. (Well, he is always right behind us, isn’t he?)

This is a NAR case, my senior doctor told me. (NAR = non active resuscitation). So, it was a relief – to us, doctor on-call and the night-shift nurses. Well, NAR does not mean we could just let the patient die, we still need to save the patient, but to a certain extend. The patient was not for intubation (putting tube into the trachea through the mouth to assist breathing) or CPR (cardiopulmonary resuscitation), that was for sure. All I need to do was to run fluids and inotropes to the maximum doses if patient desaturates and the BP drops. (Well, it was not that simple, but it’s the simplest way to explain – for now).

It was not a surprise, when her BP started to drop, then went plateau, fluctuated then dropped again despite fluid challenge and inotropic support. The heart rate rised in response to low BP. To my relief, the senior doctor had already consulted the husband regarding the current condition – that her time had not much left. I have to admit, it was not an easy task indeed, to break the bad news. Altough some people might think, it is as simple as telling ‘Your wife/daughter is going to die’. The mother noticed my ‘this-is-not-good’ face. Plus, she was from a well-educated family, of course she understands what the low BP means.

Some might immediately give this answer, ‘this is the best i can do for your daughter’. But I just could not throw it out. I was not so sure myself, that I had done enough for her. And I was still putting hopes on Allah, that the BP would respond to whatever I had given her. But Allah’s decree is always beyond our might and expectations. He would take back our love ones whenever He wishes to do so.
And at 4.30am, she breathed her last breath.

We left to settle other matters after my senior doctor consoling the family, and to allow them to spend time with the deceased before sending her to the mortuary. After a few moments, the cubicle became crowded – with the relatives.

At 6.30am, when I was about to leave to another ward for my daily duty, the mother in-law stopped me. And out of sudden, she hugged me and cried on my shoulder.
“Doktor, terima kasih sebab sabar melayan kerenah menantu saya. Terima kasih sebab cuba sedaya upaya untuk selamatkan dia.”

The mother held me even tighter, and cried even louder on my shoulder. I just hoped that I have said nothing wrong.
This time I did not try to release myself until she stopped crying.
“Nak, siapa nama kamu? Nanti kalau jumpa makcik di mana-mana, tegur makcik ya!”

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Abu Hurayra reported that the Messenger of Allah, may Allah bless him and grant him peace, said, “Remember frequently the thing that cuts off pleasures,” i.e. death.” [at-Tirmidhi]

Abu Hurayra reported the Messenger of Allah, may Allah bless him and grant him peace, said, “Race to good actions as fast as you can. What are you waiting for except delayed poverty, oppressive wealth, debilitating illness, dottering senility, a swift death or the Dajjal? Or are you waiting for an unseen evil, or the Last Hour? The Last Hour will be most bitter and terrible.“ [at-Tirmidhi]

Abu Huraira (Allah be pleased with him) reported Allah’s Messenger (may peace be upon him) as saying: When a man dies, his acts come to an end, but three, recurring charity, or knowledge (by which people) benefit, or a pious son, who prays for him (for the deceased). [Book 013, Chapter 4, Number 4005 : Sahih Muslim]

Allah Almighty says, “Every self will taste death. You will be paid your wages in full on the Day of Rising. Anyone who is distanced from the Fire and admitted to the Garden, has triumphed. The life of this world is only the enjoyment of delusion,” (3:185)

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May this physically-and-mentally-challenging-work gives me the most beneficial lesson; A reminder of Death.

It is very important to make it clear that fasting on the day of `Ashura’ – the 10th of Muharram– is of great merits in Islam. The Prophet (peace and blessings be upon him) said, “Fasting the day of `Ashura’ (is of great merits), I hope that Allah will accept it as an expiation for (the sins committed in) the previous year” (Muslim).

Also, fasting the 9th of Muharram is highly recommended by the Sunnah. Imam At-Tirmidhi reported that Ibn `Abbas (may Allah be pleased with them both) used to say: We should fast on two days: the 9th and 10th of Muharram to distinguish ourselves from the Jewish community. (At-Tirmidhi)

Explaining the virtue of fasting on the 9th and the 10th of Muharram, Dr. Muzammil H. Siddiqi, former President of the Islamic Society of North America, states:

It is the Sunnah of the Prophet (peace and blessings be upon him) to fast on the 9th and 10th of Muharram. The Prophet (peace and blessings be upon him used to fast on the day of `Ashura’. When he came to Madinah, he found out that the Jews of Madinah were also fasting on this day remembering Prophet Musa (peace and blessings be upon him). The Prophet (peace and blessings be upon him) admired this tradition and said to the Jews, “I am closer to Musa than you are.” He fasted and he also told his Companions to fast on this day.

Later, before the end of his life, the Prophet (peace and blessings be upon him) told Muslims to add the 9th day also. Thus, it is recommended to fast on both the 9th and 10th of Muharram.

Moreover, in his well-known book, Fiqh As-Sunnah, the late Sheikh Sayyed Sabiq states:

Abu Hurayrah reported: “I asked the Prophet: ‘Which Prayer is the best after the obligatory Prayers?’ He said: ‘Prayer during the mid of the night.’ I asked: ‘Which fasting is the best after that of Ramadan?’ He said, ‘The month of Allah that you call Muharram’” (Ahmad, Muslim, and Abu Dawud).

Mu`awiyyah ibn Abi Sufyan reported that he heard the Messenger of Allah say: “Concerning the day of `Ashura’, it is not obligatory upon you to fast on it as I do. Whoever wishes may fast and whoever does not wish to is not obliged to do so” (Al-Bukhari and Muslim).

It is noteworthy that Muslim scholars have stated that fasting of `Ashura’ is of three levels as follows:

Indeed, the sacred month of Muharram is a blessed and important month. It is the first month of the Hijri calendar and is one of the four sacred months concerning which Allah says, (Verily, the number of months with Allah is twelve months (in a year), so it was ordained by Allah on the Day when He created the heavens and the earth; of them, four are sacred. That is the right religion, so wrong not yourselves therein) (At-Tawbah 9: 36)

Abu Bakrah (may Allah be pleased with him) reported that the Prophet (peace and blessings be upon him) said: “Time has come back to its original state which it had when Allah created the Heavens and the Earth; the year is twelve months, four of which are sacred. Three of them are in succession: Dhul-Qa`da, Dhul-Hijja and Al-Muharram, and (the fourth being) Rajab Mudar (named after the tribe of Mudar as they used to respect this month) which stands between Jumad (ath-Thani) and Sha`ban.”

Muharram is called so because it is a sacred (muharram) month and to confirm its sanctity. Allah Almighty says, (so wrong not yourselves therein), which means do not wrong yourselves in these sacred months, because sin in these months is worse than in other months.

It was reported that Ibn `Abbas said regarding the above verse that these four months were singled out and made sacred. Sins in these months are more serious and good deeds bring a greater reward.

Qatadah said concerning this phrase (so wrong not yourselves therein) that wrongdoing during the sacred months is more serious and more sinful than wrongdoing at any other time. Wrongdoing at any time is a serious matter, but Allah gives more weight to whichever of His commands He will. Allah has chosen certain ones of His Creation. He has chosen from among the angels Messengers and from among mankind Messengers. He chose from among speech His remembrance or dhikr. He chose from among the earth the mosques, from among the months Ramadan and the sacred months, from among the days Friday and from among the nights laylat al-qadr, so venerate that which Allah has told us to venerate. People of understanding and wisdom venerate the things that Allah has told us to venerate. (Summarized from the Tafseer of Ibn Kathir, may Allah have mercy on him. Tafseer of Surat at-Tawbah, verse 36).

The Virtue of Observing More Voluntary Fasting during Muharram:

Abu Hurayrah (may Allah be pleased with him) said: The Messenger of Allah (peace and blessings be upon him) said: “The best of fasting after Ramadan is fasting Allah’ month of Muharram.” (Reported by Muslim).

The phrase “Allah’s month”, connecting the name of the month to the name of Allah in a genitive grammatical structure, signifies the importance of the month. Al-Qari said:

The apparent meaning of the above Hadith is to fast all of the month of Muharram. But it was proven that the Prophet (peace and blessings be upon him) never fasted any whole month apart from Ramadan, so this Hadith is probably meant to encourage increasing one’s fasting during Muharram, without meaning that one should fast for the entire month.

It was reported that the Prophet (peace and blessings be upon him) used to fast more in Sha`ban because he may have not learnt of the virtue of Muharram until the end of his life, before he was able to fast during this month, or because certain circumstances may happened during this month hindering him from fasting such as sickness, travel, etc. (Sharh al-Nawawi `ala Saheeh Muslim).”

~ Me ~

Ummu Hakeem Searching for the strength from the inside, Seeking for Guidance from the One who Holds the heart of the believers. Oh Allah, bestow Your Blessings upon us.

~ Ameen, ya Rabb! ~

"O Allah! [I ask you], by Your knowledge of the Unseen, and Your control over the creation: give me life as long as You know that life is best for me, and take me when death is best for me. O Allah! I also ask of You fear of You, in secret and in open; I ask of You the word of Wisdom and justice in anger and in pleasure; I ask of You moderation in poverty and affluence; I ask of You joy which does not fade; I ask of You pleasure which does not cease; I ask of You contentment with Your decree; I ask of You coolness of life after death; I ask of You the delight of looking towards Your Face; and eagerness towards meeting You, not in harmful adversity, nor in misleading afflictions. O Allah! Adorn us with the decoration of eemaan, and make us those who guide and are guided"

[al-hadeeth: Nasaa'i, al-Hakim]

Final Year Rotation & Exam

Family Medicine (Jan 2-Jan 22)Live GP OSCE: Jan 22, 2010

Orthopaedics (Jan 25 – Feb 12)Orthopaedic OSCE: Feb 12, 2010

Medicine (Feb 22 – April 2)Cardiology Long Case: March 5, 2010
Endocrinology Long Case: March 19, 2010
Respiratory/Haematology Long Case: April 2, 2010